This invention has important benefits to both the first responders of the medical community, i.e., those who must first see, on an urgent basis, victims of trauma or of nuclear, biological or chemical accidents or attacks, and to those who desire to use it, on a more considered basis, as a reference tool to aid their treatment of a wide variety of illnesses.
Surprising though it may be to both the scientific community and to the lay public in general, there is, even at this late date, incomplete agreement among medical professionals as to the names of the various body parts, as to the types of various body parts, and even as to the functions of various body parts. A careful review of the medical literature will establish that there are, in general, at least three different systems for naming body parts, namely, one followed by the anatomists, another by the surgeons, and yet another by the clinicians. It is not at all uncommon to find three (or more) different names for the same body part, and, worse yet, all too often a common name may be used by the different practitioners for different body parts. The possibilities for confusion, and medical errors, are enormous.
Although not so extensive as the naming differences, in far too many instances there is no agreement as to what kind of body part a specific part may be, nor as to the ‘real’ function of such body parts. As but one illustration, doctors who believe that a specific body part situated near a tumor is a lymph node may elect to irradiate or remove that body part at the same time that the tumor is treated, while doctors who do not believe that that body part is a lymph node probably will not treat it at that time. Thus widely different outcomes may be realized by different patients with identical conditions, just because their respective physicians hold differing opinions as to what type of body part a particular part is, and what its ‘true’ function may be.
Hundreds if not thousands of anatomical texts or reference works are presently available to researchers, or, at least, are available in medical libraries scattered throughout the world. A first responder, of course, presented with an injury other than one of the run-of-the-mill variety, simply does not have enough time to search for the reference which may be the most authoritative for that particular injury; even if he happened to have the particular text on his shelf, it is highly doubtful that he would have the time to actually consult it. And, of course, in the present state of the art, what one does not possess, one cannot consult. At first glance, the diagnosing and treating physicians may be thought to be in a better position, having the luxury of more time, but all too often their situation is scarcely better; with governmental limitations on radiologists, for example, a radiologist typically has just a few minutes—nearly always fewer than ten—in which to both read the images in question and dictate his conclusions. Formerly, it was typical for a radiologist to have only a few images per patient to read; now, it is common for a few hundred images, per patient, to be taken, leaving the radiologists with ever less time to spend on each image. Although the treating physicians may not be so rushed as the radiologists, the realities of daily practice, including the economic need to push patients through as rapidly as possible, inevitably result in little or no time to consult a number of references, many of which are not even widely available. While the system works well enough for the garden variety of problems which physicians see most frequently, it tends to break down when rare or even less common ailments are presented.
The federal government has undertaken an expensive effort, known as the Visible Human Project, to partially alleviate this problem, but its efforts to date seem to have been misdirected. At a cost in excess of a million dollars, it has frozen a human male and a female cadaver and then sliced them, reportedly at intervals of one millimeter, into over eighteen hundred slices, and photographed each slice. The results are available on the internet, but, regrettably, are of only limited utility. Only the anatomists' system for naming body parts is utilized, with no correlation to the different nomenclature systems, so the confusion of body parts is thus not alleviated. Further, one cannot locate an image of a particularly desired body part by simply typing in a name and allowing the program to search for the body part corresponding to that name. In order to locate images of a particular body part relatively quickly, the user must know both the approximate location of the body part and approximately what it looks like; the pertinent image or ‘slice’ may have in excess of fifty names of body structures surrounding the image, each with a black line running to the appropriate structure, and the names are not presented in alphabetical order but by geometrical convenience. Should a user not know the approximate location, the user may expend a great amount of time in searching for its location. But even finding the structure of interest conveys very little useful information to the user: all that the user is presented with is a set of photographic images of dessicated body parts, in thin slices, which are of little real value to the vast majority of practicing physicians. Applicants know of no clinical physicians who actually use the Visible Human database, simply because of the great difficulty in translating from cadaver images to diagnostic or reference imagery, and because the nomenclature is so often not clinically relevant.
Some treating physicians, such as radiotherapy treatment planning physicians, have available to them a computer system which can receive sets of patient images via the PACS system and display them, perhaps even rotate them at will, on an associated computer monitor. While this promotes greater visual clarity and permits easier physical handling than the long-conventional method of developing negatives of film and then viewing them by shining a light through from underneath, with regard to the actual treatment planning it is hardly advanced over the old-fashioned film-viewing method: neither method alleviates a long-standing communications problem between diagnosing and treating physicians. In both instances the images will almost certainly have been read previously by a radiologist, whose report may have identified a probable tumor in a specific body part, by name. If the body part is a familiar one to the treatment planning physician, all is well and good, but if the part is not a commonly known body part or is unfamiliar to the planning physician, problems are immediately presented. First is the problem of just which body part image is the one at issue; the name employed by the radiologist may be unfamiliar to the treatment planner, or may refer to a different body part than the one of that same name known by the planner. After—it is hoped—having successfully resolved that problem, the planner is immediately confronted with yet another: what does that body part do; is it a critical body part, or can it be eliminated or have its function diminished? It is not at all uncommon, for the less common body parts, for discussions among the treatment planning team to ensue for hours, frequently involving telephone consultation with the reading radiologist, before these questions are resolved. And then, quite commonly, the same questions must be asked and answered about much of the surrounding tissue before the treatment planners can plan one or more paths for the treating radiation. After all this has been accomplished in the abstract, it still must be translated to the concrete before any actual treatment can begin. In particular, after all the arguments have been resolved, or at least after some form of consensus has been reached, a member of the treatment planning staff must still draw, in the computer system displaying the patient images, the outline of the body part or parts to be treated, on all images (or ‘slices’) in which the part or parts of interest appear. In many instances, then, a total of three to four hours—and all too often even more—can easily be consumed by the team of treatment planners in devising a treatment plan, which inevitably increases both the cost of treatment and the time required to get treatment underway.